| A Case of Multiple Myeloma with Ameliorated Bone Pain after Treatment of Adult Fanconi Syndrome |
| Hye-Lee Kwon, M.D.1, Seung-Jin Cho, M.D.2, Young-Soo Song, M.D.3, Hun-Ho Song, M.D.1, Ji Eun Oh, M.D.3, Soo-Jin Kim, M.D.3, Hyeong-Jik Kim, M.D.3 and Jeong-Woo Noh, M.D.3 |
Department of Internal Medicine1
and Pathology2
College of Medicine Hallym University, Hallym University Kidney Research Institute3
Seoul, Korea |
| 증례 : Fanconi 증후군 치료 후 골동통이 호전된 다발성 골수종 1예 |
| 권혜리1, 조성진2, 송영수3, 송헌호1, 오지은3, 김수진3, 김형직3, 노정우3 |
| 한림대학교 의과대학 강동성심병원 내과1, 병리과2, 신장연구소3 |
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| Abstract |
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Adult Fanconi syndrome is characterized by variable abnormalities caused by renal proximal transport defects, resulting in glycosuria, aminoaciduria, bicarbonaturia, uricosuria and phosphaturia. A 57-yearold man with κ-light chain multiple myeloma, undergoing chemotherapy with prednisolone and melphalan for 17 month, was admitted with spontaneous femoral neck fracture and was consulted due to polyuria and refractory metabolic acidosis immediately after hemiarthroplasty. The laboratory values showed normal anion gap metabolic acidosis with normal urinary anion gap, hypokalemia, hypouricemia, hypophosphatemia at the time of consultation. After partial correction of acidemia, the fractional excretion of HCO3 - was 11.9%, it was interpreted as proximal renal tubular acidosis. 24-hour urine collection showed increased level of excretion for most aminoacids. Diffuse osteopenia and multiple compression fractures on spine were detected on radiological examinations. Also, osteoporosis and osteomalacia was suggested during his clinical course.
After the diagnosis of Fanconi syndrome was made, treatment was started with sodium bicarbonate, potassium citrate, calcitriol, calcium carbonate along with phosphate rich diet. Laboratory abnormalities were corrected and refractory multiple bone pain was ameliorated with these treatment.
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| Key Words:
Fanconi syndrome, Multiple myeloma, Osteomalacia |
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